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Rosacea
Treatment
Thickening Skin
Subtype: Phymatous
rosacea
Surgical procedures are generally used
to remove the thick skin and re-sculpt the area.
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Surgical Treatments Lasers and other light therapies, dermabrasion, and electrocautery
are surgical procedures used by dermatologists to re-sculpt the
skin. To achieve best results, more than one these surgical
procedures may be used. The following describes each of these
treatments:
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Lasers and other light
therapies. While earlier laser treatments removed the top
layers of the skin, the newer erbium lasers and the fractional
laser can smooth the skin without removing a significant portion
of skin. Other lasers and light therapies also may be used.
To see best results, 1 to 3 treatments are generally necessary
for laser surgery. Treatments are typically scheduled for every
4 to 8 weeks. Other light therapies may require more treatment
sessions. For instance, intense pulsed light (IPL) may require 1
to 5 sessions, with a patient returning every 3 weeks for
another treatment.
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Dermabrasion.
This surgical
resurfacing technique treats deep defects of the skin such as
acne scars, heavy wrinkles, and the thickening skin of rosacea.
To resurface the skin using dermabrasion, a dermatologist uses a
surgical tool that sands off the upper layers of the skin. As
the skin heals, new layers of skin appear that are smoother in
appearance.
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Electrocautery:
During this
surgical procedure, a dermatologist removes the thickened skin
with the hot tip of an electrode. As the skin heats up, the top
layers of excess skin are scraped off.

Before treatment |

After treatment with electrocautery |
(Photos used with permission of the American Academy of
Dermatology National Library of Dermatologic Teaching Slides) |
Effectiveness: All of these
surgical treatments can be effective in treating thickening skin.
Which procedure is used depends on a number of factors including the
patient’s medical history.
Side effects: The risk of side
effects is low in the hands of a physician who has experience using
these devices and in-depth medical knowledge of the skin. In skilled
hands, side effects tend to be limited to temporary bruising,
redness, or swelling. Darker or lighter spots on the skin and
scarring can occur.
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Other Treatment
Options
In some cases, your dermatologist may discuss treatment to
control early sights of thickening skin, and less commonly used
treatment may be an option.
References:
American Academy of Dermatology. “Acne and Rosacea Getting You
Down? Laser, Light and Cosmetic Treatments Give Patients a
Much-Needed Boost.” News release issued February 3, 2008. Last accessed June 4, 2008.
Crawford GH, Pelle MT, James WD. “Rosacea: I. Etiology,
pathogenesis, and subtype classification.” J Am Acad Dermatol
2004; 51: 327-41; quiz 42-4.
James WD, Berger TG, Elston DM. “Rosacea.” In: Andrews’
Diseases of the Skin, 10th edition.
Canada. Saunders Elsevier: 2006. 246-8.
Pelle MT, Crawford GH, James WD. “Rosacea: II. Therapy.” J Am
Acad Dermatol 2004; 51: 499-512; quiz 3-4.
Webster GF. “Rosacea and Related Disorders.” In: Bolognia JL,
Jorizzo JL, Rapini RP et al, editors. Dermatology,
Spain, Mosby Elsevier; 2008. p. 509.

All
content solely developed by the American Academy of Dermatology |
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Visibly thickening
facial skin
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In the beginning: Skin
swells a bit and becomes smoother and oiler
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As progresses: Pores
become more visible and swelling increases
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Skin eventually
develops thick, bumpy appearance (When the skin on
the nose thickens, the condition is called
rhinophyma. Thickening skin also can develop on the
cheeks, chin, forehead, one or both ears, and
eyelids.)
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